Study finds pandemic led to decline in exercise performance in children and young adults

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Children and young adults experienced a decline in cardiopulmonary exercise performance during the COVID-19 pandemic, according to a new study by researchers at Children’s Hospital of Philadelphia (CHOP). The study, published in the journal Pediatric Cardiology, found a notable decrease in aerobic activity, which was most pronounced in children and young adults who had the highest exercise performance before the pandemic began.

“Our study shows that the COVID-19 pandemic led to a decrease in physical activity and an increase in sedentary behavior by children and young adults, which in turn led to a decrease in cardiopulmonary exercise performance,” said senior study author Julie Brothers, MD, a cardiologist in the Cardiac Center and Director of the Lipid Heart Clinic at Children’s Hospital of Philadelphia. “Although sports activities and in-person schooling have largely resumed, future studies should examine if exercise performance has returned to pre-pandemic values. This study has public health implications and demonstrates the importance of physical activity on overall cardiovascular health.”

The researchers analyzed data from 122 patients between the ages of 6 to 22 years who had a serial cardiopulmonary exercise test (CPET) at CHOP before the COVID-19 pandemic (January 1, 2019 to March 13, 2020) and at least once during the COVID-19 pandemic (June 1, 2020 to May 7, 2021).

Of the patients analyzed, most patients (81%) attended in-person school before the pandemic, whereas only 9% of patients received in-person schooling during the pandemic; a plurality of patients had either hybrid (12%) or remote (36%) school learning during the pandemic period. Nearly half (43%) of patients reported a decrease in physical activity during pandemic.

Both males and females in the study saw an increase in BMI during the pandemic and a significant decrease in aerobic capacity, even after accounting for growth between stress tests. The researchers observed the greatest decrease in exercise performance among those who were the most aerobically fit pre-pandemic. One explanation for this finding, the researchers suggest, is that the most aerobically fit subjects were likely participating in competitive, structured sports before the pandemic, whereas those activities were canceled during the pandemic period, resulting in a more significant decline in physical activity.

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